计算机辅助设计妥布霉素个体化给药方案

Computer-assisted Medication Design on Personalized Use of Tobramycin

目的建立一种简便的计算机辅助设计妥布霉素个体化给药方案。方法根据病人的性别、年龄、身高、体重、血肌苷浓度,计算血清肌苷清除率、药物清除率和消除速率常数,以药动学模型理论和药效学原理为依据,用Excel编写模拟计算程序。结果只要输入病人病理生理参数,可输出男性、女性、小儿、老人、肥胖病人和水肿病人肌肉注射、间歇静脉滴注的给药剂量和稳态血药浓度。小儿剂量可由小儿体表面积与成人体表面积之比折算而成。而且由于Excel具有重复计算功能,改变输入参数值,可一步得到所有结果供临床参考。该方法适用于其他氨基糖苷类抗生素。结论根据药动学参数和病人的生理特点,可利用Excel函数设计妥布霉素个体化给药方案,该法简单、可靠、直观。

Objective To establish a simple method for computer-assisted medication design on personalized use of tobramycin. Methods To calculate serum camine clearance, drug clearance and elimination rate constant according to gender, age, body height, body weight, and serum camine concentration of patients. Then program calculation process of dosage for ideal serum-drug concentration according to the principle of pharmacokinetics and pharrnacodynamic＇s. Results Administer dosage and steady serum drug concentration for male, female, fat patient, and dropsical patient under intramuscular injection and intravenous drip can be obtained after input physiological and pathological parameters of patients. Dosage for children can be converted from the ratio of children＇ s body surface area （BSA） and adult＇s BSA. Moreover, because of the repeat calculation function of Excel, all results can be obtained rapidly after inputted parameters values being changed. This method is suitable for other aminoglycoside antibiotics. Conclusion The method for computer-assisted medication design on personalized use of tobramycin according to pharmacokinetic parameters and physic parameters of patient is simple, reliable, and directly perceived through the senses.